Innovations in Cardiology

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Q: What drew you to Einstein? A: I trained at Temple University for general surgery. I was raised in New Jersey, and went to medical school in New Jersey, so I’ve been in this area for a while. My husband, Jay Simhan, also works for Einstein as a surgeon in the Urology department; we both were recruited to Einstein at the same time. Although we were recruited nationally to various cities, we always loved Philadelphia and loved the mission of Einstein. It just worked out that we both found positions that we felt would satisfy what we wanted. Q: What are your clinical interests? A: I like to focus my practice on aortic surgery in particular. This includes minimally-invasive aortic valves, transcatheter aortic valves, aortic roots, aortic aneurysms, and endovascular aortic surgery. I am one of the few surgeons in the region with specific training in aortic conditions and I have a fair amount of experience performing surgeries within this subspecialty. Q: So you perform procedures at Einstein Medical Center Montgomery, and you’re also at Einstein Medical Center Philadelphia? A: Yes. This week, I operated at Einstein Philadelphia on Tuesday and Wednesday, and then I operated at Einstein Montgomery on Monday and Thursday. Q: Do you have a favorite book, or books? A: I like science fiction. Any sort of sci-fi type book, dystopian, post-apocalyptic, any Isaac Asimov book, HG Wells, any old-school sci-fi book, I’ve read it, and loved it. Q: Favorite movie? A: Star Wars. Really, the old Star Wars. We’re going to skip the three episodes (Episodes I, II, and III) that were totally awful, and then the new Star Wars. I also really, really like the Marvel Universe movies. I could just watch those movies, when they’re on TV. Just turn the TV on, “Oh! Captain America!” Originally appeared in Einstein Healthcare Network’s Perspectives blog. To access the blog and more information about network services, please visit www.einstein.edu. Q: What is there about you that people might not know? A: Many people don’t know this, but I was born in Romania. I came to the United States as a teenager at the start of my high school education in this country. Moving here basically uprooted my entire life in Romania, I came here with my dad to live the American dream. by Jeff Meade for Einstein Perspectives Heart Disease Is as American as Apple Pie* Heart disease continues to rise in the U.S. Heart surgeon Dr. Alexandra Tuluca, Associate Chief of Cardiac Surgery at Einstein Healthcare Network, explains how the American lifestyle contributes to this public health concern. Q: Are men at higher risk of heart disease than women? A: A lot of traditional research studies investigating the effects of heart disease largely included male patients only. Since female patients were not often included with equal representation in these older studies, there was a misconception by many that women don’t get heart disease and that is categorically not true. As one of only a few female heart surgeons in this country, I see plenty of women with this condition. One in five women in this country dies of heart disease. Q: You were born in Romania where your grandfather was also a surgeon. Did that influence your desire to become a surgeon? A: Definitely. For as long as I can remember I’ve always wanted to be a doctor. Growing up, I was very close with him and he was a well-regarded surgeon in his community in Romania. I am living the American dream: I moved here as a young teenager, worked hard, and after medical school, I became greatly interested in cardiac surgery, following in the footsteps of my grandfather. Q: Has technology changed how you perform surgery since the beginning of your career? A: I’ve seen a shift toward minimally invasive procedures. For example, nowadays, I routinely perform catheterbased procedures that can be done without making an incision in the chest and repair heart valves. Heart surgery didn’t establish itself until the late 1950s, and we’ve made exponential progress in not only the surgeries, but also the recovery process and reducing risks. 8
Q: Is heart disease on the rise globally? A: Globally, in comparable countries to the U.S., deaths from heart disease are on the decline. However, in the U.S., deaths from heart disease are on the rise. Diet – mostly portion sizes – is a huge contributor to this problem along with obesity and inactivity. France and Japan, for example, have one of the lowest rates of heart disease because part of the culture involves a lot of physical activity during the day there, but it surprisingly might not include going to the gym; it’s walking to work or the store. Americans drive everywhere, and activity isn’t built into our routine. I also think our lives are a lot more stressful – stress contributes to heart health. Q: In addition to taking medication, how can patients improve their heart health? A: Increasing activity, practicing portion control and de-stressing are the biggest things. Incorporating some form of physical activity or exercise into the daily routine; 30-40 minutes, 4-5 days a week of just walking. It’s a part of our daily routine that’s missing and is what probably needs to change. People underestimate the value of very basic physical activity because they think they must get a gym membership and start working out, but it’s even simpler than that. An effort at even basic physical activity improves cardiovascular health and importantly reduces stress. * This article first appeared in Philadelphia Magazine’s 2020 Go Red for Women special edition. Alexandra Tuluca, MD Associate Chief of Cardiac Surgery for Einstein Healthcare Network Dr. Alexandra Tuluca graduated summa cum laude with Honors from Fairleigh Dickinson University, and received her medical degree at Robert Wood Johnson Medical School in New Jersey where she was inducted into the Alpha Omega Alpha medical society for academic excellence. She subsequently completed her general surgery training at Temple University Hospital in Philadelphia, Pennsylvania and went on to complete her fellowship in cardiothoracic surgery at the Texas Heart Institute/Baylor College of Medicine in Houston, Texas. Dr. Tuluca is dual-board-certified in thoracic surgery and general surgery by the American Board of Thoracic Surgery. She specializes in minimally invasive valve, coronary bypass and aortic aneurysm heart surgery. In addition, she performs complex re-operative valvular surgery and adult congenital surgery. She was recognized by the Pennsylvania Medical Society as a Pennsylvania Top Physician Under 40 in 2016. She is an active member of the Society of Thoracic Surgeons, Women in Thoracic Surgery, and a fellow of the American College of Surgeons. 9
Page 1 and 2: Innovations in Cardiovascular Care
Page 3 and 4: Meet Raymond L. Singer, MD Raymond
Page 5 and 6: Meet Sean F. Janzer, MD Patient Com
Page 7: Meet Alexandra Tuluca, MD Alexandra
Page 11 and 12: Earlier Valve Problem McCabe first

Innovations in Cardiology

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